Kesher Israel Congregation
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Membership Application

KI Membership Application

Date of Application
Address(Required)
Anniversary Date (If applicable)

Member #1 Information

Member 1 - Name
Member 1 - Birth Date(Required)
Member 1 - Jewish?
Member 1 - Tribe (If known)
Format: "Your Hebrew Name" ben (son of)/bat (daughter of) "Your Father's Hebrew Name" v' (and) "Your Mother's Hebrew Name"

Member #2 Information

Member 2 - Name
Member 2 - Birth Date
Member 2 - Jewish?
Member 2 - Tribe (If known)
Format: "Your Hebrew Name" ben (son of)/bat (daughter of) "Your Father's Hebrew Name" v' (and) "Your Mother's Hebrew Name"

Additional Information

Do you have any children under the age of 21?(Required)

Child 1

Child 1 - Birth Date
Format: "Child's Hebrew Name" ben (son of)/bat (daughter of) "Child's Father's Hebrew Name" v' (and) "Child's Mother's Hebrew Name"

Yahrzeit Information

Anniversary of a Loved One's Death - Please complete if you would like Yahrzeit notifications.
Select date MM slash DD slash YYYY
Yahrzeit 1 - After Sundown?
Select date MM slash DD slash YYYY
Yahrzeit 2 - After Sundown?
Select date MM slash DD slash YYYY
Yahrzeit 3 - After Sundown?


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